2. 
3. Adopt Cedar Hill Advanced Notification Requirement
   The City must be notified seven (7) days in advance of the exact date of the cleanup so that arrangements can be made to have the trash bags disposed of promptly.
5. Name of Adopter/ Applicant/ Organization*
6. Contact Person/ Authorized Representative*
7. Phone Number*
8. Email*
10. Date and Time of Cleanup*
    Date and Time of Cleanup

    Date and Time of Cleanup
11. Location of Cleanup*
12. How many participants?*
14. All requests for cleanup supplies and trash pickup must be made at least seven (7) days prior to the cleanup event.
16. What supplies do you need?*

    Only check items that you need.

    1. YES, I need safety vests.
    2. YES, I need trash grabbers.
    3. YES, I need trash bags.
    4. YES, I need gloves.
    5. YES, I need cooling towels (summer cleanups only).
    6. YES, I need beanies (winter cleanups only)
    7. NO, I do not need ANY supplies.
17. Do you need staff to pick up your filled trash bags?*

    1. YES, please pick up my trash bags.
    2. NO, I will dispose of my trash bags.

    Place filled trash bags under the Adopt Cedar Hill sign or next to the closest public trash bin if the cleanup is in a park.

21. FREE T-Shirts are available as supplies last. If the requested shirt size is not available, a size larger will be provided. If a size larger is not available, a size smaller will be provided. Total number of requested shirts must be less than or equal to the number of volunteers for the cleanup event.
23. How many SM T-Shirts?

    Leave blank if you do not want a SMALL shirt.

24. How many MED T-Shirts?

    Leave blank if you do not want a MEDIUM shirt

25. How many LRG T-Shirts?

    Leave blank if you do not want a LARGE shirt.

27. How many XL T-Shirts?

    Leave blank if you do not want a XL shirt.

28. How many 2XL T-Shirts?

    Leave blank if you do not want a 2XL shirt.

29. How many 3XL T-Shirts?

    Leave blank if you do not want a 3XL shirt.

33. Required Form
    Cleanup Report

    Cleanup Report must be submitted within five (5) days of a scheduled cleanup event to receive credit. Photos are highly encouraged.
34. Required Form
    Safety Tips for Volunteers (PDF)

    Hand a copy of the safety tips to every volunteer OR read aloud before the cleanup event begins.
Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field